| Buffalo Prairie Dental Care Of Pittsfield, Inc | |
|
850 N Jackson St Pittsfield IL 62363-1206 | |
| (217) 285-4084 | |
| Not Available |
| Full Name | Buffalo Prairie Dental Care Of Pittsfield, Inc |
|---|---|
| Speciality | Dentist |
| Location | 850 N Jackson St, Pittsfield, Illinois |
| Authorized Official Name and Position | Roy Glenn Northcutt (OWNER) |
| Authorized Official Contact | 2172854084 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Buffalo Prairie Dental Care Of Pittsfield, Inc 850 N Jackson St Pittsfield IL 62363-1206 Ph: (217) 285-4084 | Buffalo Prairie Dental Care Of Pittsfield, Inc 850 N Jackson St Pittsfield IL 62363-1206 Ph: (217) 285-4084 |
| NPI Number | 1760667307 |
|---|---|
| Provider Enumeration Date | 01/02/2008 |
| Last Update Date | 01/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760667307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0190242471 (Illinois) | Secondary |
| 122300000X | Dentist | (Illinois) | Primary |
Buffalo Prairie Dental Care, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 850 N Jackson St, Pittsfield, IL 62363 Phone: 217-285-4084 | |
Dan K. Speckhart D.m.d. And Douglas J. White D.m.d., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E Fayette St, Pittsfield, IL 62363 Phone: 217-285-5553 |